Outcome of incudostapedial reconstruction with endoscopic modified butterfly tympanoplasty

Year 2021, Volume: 46 Issue: 2, 640 - 645, 30.06.2021

Mehmet Kaplama , Burak Erden , Semih Ak

https://doi.org/10.17826/cumj.871946

Abstract

Purpose: The aim of this study was to evaluate the results of endoscopic butterfly tympanoplasty in perforations that involve the ossicular chain pathologies.
Materials and Methods: We assessed the outcome of endoscopic modified butterfly tympanoplasty in 29 patients. The study included those with large tympanic membrane perforations covering the manubrium of malleus and has ossicular chain pathologies, operated via endoscopic transcanal tympanoplasty.
Results: The tympanic membrane closure rate was 89.7% (26 of 29 ears). The mean air conduction in the pre- and postoperative period was 37.75±5.20 dB and 18.96±6.52 dB, respectively, with a statistically significant decrease of 18.79±7.33. The mean pre- and the postoperative air-bone gap was 27.82±4.74 dB and 9.17±4.89 dB, respectively, with a statistically significant decrease of 18.62±7.11
Conclusion: The endoscopic modified butterfly tympanoplasty technique is a minimally invasive technique that can provide successful results in large perforations with defective incudostapedial joint.

Keywords

Tympanoplasty, Butterfly, Perforation, Endoscopic, Incudostapedial bridge

Endoskopik modifiye kelebek timpanoplasti ile incudostapedial rekonstrüksiyon sonuçları

Abstract

Amaç: Bu çalışmanın amacı, kemikçik zincir patolojilerini de içeren perforasyonlarda endoskopik kelebek timpanoplasti sonuçlarını değerlendirmektir.
Gereç ve Yöntem: Çalışmada 29 hastada endoskopik modifiye kelebek timpanoplasti sonuçlarını değerlendirdik. Çalışmaya malleus manubriumunu içeren geniş timpanik membran perforasyonları olan ve kemikçik zincir patolojileri olanlar, endoskopik transkanal timpanoplasti ile ameliyat edilen hastalar dahil edildi.
Bulgular: Timpanik membran kapanma oranı % 89.7 idi (n=26). Ameliyat öncesi ve sonrası dönemde ortalama hava iletimi sırasıyla 37.75 ± 5.20 dB ve 18.96 ± 6.52 dB idi. Ameliyat sonrası dönemdeki hava yolu saf ses ortalamalarındaki düşüş istatistiksel olarak anlamlı 18.79 ± 7.33 bulundu. Ameliyat öncesi ve sonrası hava-kemik aralığı sırasıyla 27,82 ± 4,74 dB ve 9,17 ± 4,89 dB olarak bulundu. Ameliyat öncesi ve sonrası karşılaştırıldığında hava kemik aralığındaki azalma 18,62 ± 7,11 olarak bulundu ve istatistiksel olarak anlamlı olarak değerlendirildi.
Sonuç: Endoskopik modifiye kelebek timpanoplasti tekniği, incudostapedial eklem defektli büyük perforasyonlarda başarılı sonuçlar verebilen minimal invaziv bir tekniktir.

Keywords

Timpanoplasti, Kelebek, Perforasyon, Endoskopik, Incudostapedial eklem

References

• 1. Jeffery CC, Shillington C, Andrews C, et al. The palisade cartilage tympanoplasty technique: a systematic review and meta-analysis. J Otolaryngol Head Neck Surg. 2017 Jun 17;46(1):48. doi: 10.1186/s40463-017-0225-z. PubMed PMID: 28623942; PubMed Central PMCID: PMCPMC5473980.
• 2. James AL. Endoscope or microscope-guided pediatric tympanoplasty? Comparison of grafting technique and outcome. Laryngoscope. 2017 Nov;127(11):2659-2664. doi: 10.1002/lary.26568. PubMed PMID: 28304079.
• 3. Gross CW, Bassila M, Lazar RH, et al. Adipose plug myringoplasty: an alternative to formal myringoplasty techniques in children. Otolaryngol Head Neck Surg. 1989 Dec;101(6):617-20. doi: 10.1177/019459988910100601. PubMed PMID: 2512548.
• 4. Eavey RD. Inlay tympanoplasty: cartilage butterfly technique. Laryngoscope. 1998 May;108(5):657-61. doi: 10.1097/00005537-199805000-00006. PubMed PMID: 9591541.
• 5. Mauri M, Lubianca Neto JF, Fuchs SC. Evaluation of inlay butterfly cartilage tympanoplasty: a randomized clinical trial. Laryngoscope. 2001 Aug;111(8):1479-85. doi: 10.1097/00005537-200108000-00027. PubMed PMID: 11568587.
• 6. Ghanem MA, Monroy A, Alizade FS, et al. Butterfly cartilage graft inlay tympanoplasty for large perforations. Laryngoscope. 2006 Oct;116(10):1813-6. doi: 10.1097/01.mlg.0000231742.11048.ed. PubMed PMID: 17003724.
• 7. Alain H, Esmat NH, Ohad H, et al. Butterfly myringoplasty for total, subtotal, and annular perforations. Laryngoscope. 2016 Nov;126(11):2565-2568. doi: 10.1002/lary.25904. PubMed PMID: 27411314.
• 8. Kaya I, Benzer M, Gode S, et al. Butterfly cartilage tympanoplasty: an alternative new technique instead of conventional surgery method. Eur Arch Otorhinolaryngol. 2017 Sep;274(9):3311-3314. doi: 10.1007/s00405-017-4645-1. PubMed PMID: 28625006.
• 9. Committee on Hearing and Equilibrium guidelines for the evaluation of results of treatment of conductive hearing loss. AmericanAcademy of Otolaryngology-Head and Neck Surgery Ffoundation, Inc. Otolaryngol Head Neck Surg. 1995 Sep;113(3):186-7. doi: 10.1016/S0194-5998(95)70103-6. PubMed PMID: 7675477.
• 10. Ozgur A, Dursun E, Terzi S, et al. Endoscopic butterfly cartilage myringoplasty. Acta Otolaryngol. 2016;136(2):144-8. doi: 10.3109/00016489.2015.1101782. PubMed PMID: 26492853.
• 11. Choi N, Noh Y, Park W, et al. Comparison of Endoscopic Tympanoplasty to Microscopic Tympanoplasty. Clin Exp Otorhinolaryngol. 2017 Mar;10(1):44-49. doi: 10.21053/ceo.2016.00080. PubMed PMID: 27334511; PubMed Central PMCID: PMCPMC5327595.
• 12. Lee SA, Kang HT, Lee YJ, et al. Microscopic versus Endoscopic Inlay Butterfly Cartilage Tympanoplasty. J Audiol Otol. 2019 Jul;23(3):140-144. doi: 10.7874/jao.2018.00549. PubMed PMID: 31234245; PubMed Central PMCID: PMCPMC6646895.
• 13. O'Reilly RC, Cass SP, Hirsch BE, et al. Ossiculoplasty using incus interposition: hearing results and analysis of the middle ear risk index. Otol Neurotol. 2005 Sep;26(5):853-8. doi: 10.1097/01.mao.0000185054.92265.b7. PubMed PMID: 16151328.
• 14. Galy-Bernadoy C, Akkari M, Mathiolon C, et al. Comparison of early hearing outcomes of type 2 ossiculoplasty using hydroxyapatite bone cement versus other materials. Eur Ann Otorhinolaryngol Head Neck Dis. 2014 Nov;131(5):289-92. doi: 10.1016/j.anorl.2013.03.009. PubMed PMID: 24924117.
• 15. Demir B, Binnetoglu A, Sahin A, et al. Long-term outcomes of ossiculoplasty using bone cement. J Laryngol Otol. 2019 Aug;133(8):658-661. doi: 10.1017/S0022215119001300. PubMed PMID: 31270001.
• 16. Gungor V, Atay G, Bajin MD, et al. Comparison of various bone cement ossiculoplasty techniques and functional results. Acta Otolaryngol. 2016 Sep;136(9):883-7. doi: 10.3109/00016489.2016.1172255. PubMed PMID: 27118255.
• 17. Sarkar S. A review on the history of tympanoplasty. Indian J Otolaryngol Head Neck Surg. 2013 Dec;65(Suppl 3):455-60. doi: 10.1007/s12070-012-0534-5. PubMed PMID: 24427697; PubMed Central PMCID: PMCPMC3889360.
• 18. Dornhoffer JL. Hearing results with cartilage tympanoplasty. Laryngoscope. 1997 Aug;107(8):1094-9. doi: 10.1097/00005537-199708000-00016. PubMed PMID: 9261014.
• 19. Hod R, Buda I, Hazan A, et al. Inlay "butterfly" cartilage tympanoplasty. Am J Otolaryngol. 2013 Jan-Feb;34(1):41-3. doi: 10.1016/j.amjoto.2012.08.004. PubMed PMID: 22975316.
• 20. Angeli SI, Kulak JL, Guzman J. Lateral tympanoplasty for total or near-total perforation: prognostic factors. Laryngoscope. 2006 Sep;116(9):1594-9. doi: 10.1097/01.mlg.0000232495.77308.46. PubMed PMID: 16954986.